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Oral ingestion of hexavalent chromium through drinking water and cancer mortality


Hexavalent chromium is a known carcinogen when inhaled, but its carcinogenic potential when orally ingested remains controversial. Water contaminated with hexavalent chromium is a worldwide problem, making this a question of significant public health importance.

The new study:
A group of researchers from Greece conducted an ecological mortality study within the Oinofita region of Greece, where water has been contaminated with hexavalent chromium.

The researchers calculated gender, age, and period standardized mortality ratios (SMRs) for all deaths, cancer deaths, and specific cancer types of Oinofita residents over an 11-year period (1999 - 2009), using the greater prefecture of Voiotia as the standard population. In total, 474 deaths were observed during this period. The SMR for all cause mortality was 98 (95% CI 89-107) and for all cancer mortality 114 (95% CI 94-136).

The SMR for primary liver cancer was 1104 (95% CI 405-2403, p-value<0.001). Furthermore, statistically significantly higher SMRs were identified for lung cancer (SMR=145, 95% CI 100-203, p-value=0.047) and cancer of the kidney and other genitourinary organs among women (SMR=368, 95% CI 119-858, p-value=0.025). Elevated SMRs for several other cancers were also noted (lip, oral cavity and pharynx 344, stomach 121, female breast 134, prostate 128, and leukaemias 168), but these did not reach statistical significance.

The results of the research were published on-line May 24 in the journal Environmental Health. The authors concluded that the observed elevated cancer mortality in the Oinofita area of Greece supports the hypothesis of hexavalent chromium carcinogenicity via the oral ingestion pathway of exposure. They also recommend further studies to determine whether this association is causal, and to establish preventive guidelines and public health recommendations.

The original study

Athena Linos, Athanassios Petralias, Costas A Christophi, Eleni Christoforidou, Paraskevi Kouroutou, Melina Stoltidis, Afroditi Veloudaki, Evangelia Tzala, Konstantinos C. Makris, Margaret R Karagas, Oral ingestion of hexavalent chromium through drinking water and cancer mortality in an industrial area of Greece - An ecological study, Environmental Health, 2011. doi:10.1186/1476-069X-10-50

Related studies: (newewst first)

A.H. Stern, A quantitative assessment of the carcinogenicity of hexavalent chromium by the oral route and its relevance to human exposure, Environ. Res. 110 (2010) 798-807. doi: 10.1016/j.envres.2010.08.002

M.D. Stout, R.A. Herbert, G.E. Kissling, B.J. Collins, G.S. Travlos, K.L. Witt, R.L. Melnick, K.M. Abdo, D.E. Malarkey, M.J. Hooth, Hexavalent chromium is carcinogenic to F344/N rats and B6C3F1 mice after chronic oral exposure, Environ. Health Perspect., 117 (2009) 716-722. doi: 10.1289/ehp.0800208

A.H. Smith, C.M. Steinmaus, Health effects of arsenic and chromium in drinking water: recent human findings, Annu. Rev. Public Health, 30 (2009) 107-122. doi: 10.1146/annurev.publhealth.031308.100143

B.D. Kerger, W.J. Butler, D.J. Paustenbach, J. Zhang, S. Li, Cancer mortality in chinese populations surrounding an alloy plant with chromium smelting operations, J. Toxicol. Environ. Health A, 72 (2009) 329-344. doi: 10.1080/15287390802529898

J.J. Beaumont, R.M. Sedman, S.D. Reynolds, C.D. Sherman, L.H. Li, R.A. Howd, M.S. Sandy, L. Zeise, G.V. Alexeeff, Cancer mortality in a Chinese population exposed to hexavalent chromium in drinking water, Epidemiology, 19 (2008) 12-23. doi: 10.1097/EDE.0b013e31815cea4c

A.H. Smith, Hexavalent chromium, yellow water, and cancer: a convoluted saga, Epidemiology, 19 (2008) 24-26. doi: 10.1097/EDE.0b013e31815c40dc

R.M. Sedman, J. Beaumont, T.A. McDonald, S. Reynolds, G. Krowech, R. Howd, Review of the evidence regarding the carcinogenicity of hexavalent chromium in drinking water, J. Environ. Sci. Health C Environ. Carcinog. Ecotoxicol. Rev., 24 (2006) 155-182. doi: 10.1080/10590500600614337

M. Costa, Potential hazards of hexavalent chromate in our drinking water, Toxicol. Appl. Pharmacol., 188 (2003) 1-5. doi: 10.1016/S0041-008X(03)00011-5

D.M. Proctor, J.M. Otani, B.L. Finley, D.J. Paustenbach, J.A. Bland,  N. Speizer, E.V. Sargent, Is hexavalent chromium carcinogenic via ingestion? A weight-of-evidence review, J. Toxicol. Environ. Health A, 65 (2002) 701-746. doi: 10.1080/00984100290071018

M. Costa, Toxicity and carcinogenicity of Cr(VI) in animal models and humans, Crit. Rev. Toxicol., 27 (1997) 431-442. doi:10.3109/10408449709078442

Related EVISA Resources

Link database: Toxicity of chromium

Related EVISA News

November 11, 2010: Deemed Essential to Health for Decades, Chromium Has No Nutritional Effect, UA Researchers Show
January 19, 2011: EPA Issues Guidance for Enhanced Monitoring of Hexavalent Chromium in Drinking Water
November 7, 2010: US EPA offers chance to speak out against hexavalent chromium
September 15, 2010: EPA accuses chromium industry of withholding lung cancer study
 June 12, 2010: Chromium(VI) much more toxic than chromium(III): At least for freshwater algae a paradigm to revise?
May 25, 2010: New OSHA Hexavalent Chromium Requirement
February 17, 2010: Hexavalent Chromium: OSHA deadline for engineering controls approaching
May 28, 2009: Hexavalent chromium rule added to revised OSHA Shipyard Industry Document
February 6, 2008: OSHA Issues Enforcement Procedures Directive for Hex Chrome Standards
May 17, 2007: Hexavalent Chromium in Drinking Water Causes Cancer in Lab Animals
April 24, 2007: Nutrigenomics: The role of chromium for fat metabolism revisited
April 12, 2007: OSHA Agrees to Monitor Worker Exposure to Hexavalent Chromium-Containing Cement
October 4, 2006: OSHA Issues Hexavalent Chromium Guidance for Small Businesses
June 8, 2006: Scientific journal adds fuel to ongoing chromium debate
February 28, 2006: OSHA Issues Final Standard on Hexavalent Chromium
March 20, 2005: United Kingdom's Food Standards Agency granted derogation to Chromium (III) compounds as a food supplement
November 23, 2004: Chromium (III) - not only therapeutic?

last time modified: May 28, 2011


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